In a recent article in Family Medicine,1 Fleischer and colleagues offer several interesting comments based on minimal data. Whether family physicians function as gatekeepers or medical sieves, their beliefs are meaningful to specialists, and in this case, skin specialists. The following paragraphs expound on several of the observations made by Fleischer and coauthors.
Family physicians are now required to have a minimum of 60 hours of dermatologic training, although most programs allocate 135 hours. Younger family physicians are superior to their older counterparts in the diagnosis and treatment of skin disorders. Twenty-two percent of family practice residents feel somewhat unprepared to treat skin ailments. Dermatologic problems account for 7.2% of all office visits to family physicians, which is higher than the previous decade. The most common skin disorders diagnosed by these physicians were dermatitis (16.4% of all diagnoses), pyoderma (13.7%), warts (8%), and tinea (5.4%). On the other hand, the most common skin disorders diagnosed by dermatologists were acne (18%), dermatitis (13.1%), actinic keratosis (11.5%), and skin cancer (7.6%).